Provider Demographics
NPI:1770787954
Name:KADIYALA, SILPA (DMD)
Entity type:Individual
Prefix:DR
First Name:SILPA
Middle Name:
Last Name:KADIYALA
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:35 SHELTON DR
Mailing Address - Street 2:
Mailing Address - City:ROYERSFORD
Mailing Address - State:PA
Mailing Address - Zip Code:19468-2866
Mailing Address - Country:US
Mailing Address - Phone:203-848-8587
Mailing Address - Fax:
Practice Address - Street 1:35 SHELTON DR
Practice Address - Street 2:
Practice Address - City:ROYERSFORD
Practice Address - State:PA
Practice Address - Zip Code:19468-2866
Practice Address - Country:US
Practice Address - Phone:203-848-8587
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-06-12
Last Update Date:2020-12-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA218451223G0001X
PADS0389771223G0001X, 1223P0221X
NJ22DI023529001223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0221XDental ProvidersDentistPediatric Dentistry
No1223G0001XDental ProvidersDentistGeneral Practice